Our Services in Crisis………My rambling thoughts….

A long blog ….sorry…..

A variety of circumstances has recently found me trying to work out what has gone wrong with our wonderful NHS and services in general…..I was at a meeting recently where they spoke about 2040, that being the year they predict the NHS will implode on itself, such is the state of our wonderful service. That will be the year that those born in the new year will be 21 years of age. Well, looking at the current crisis I wonder if the NHS has that long to go before crumbling under underfunding?

It’s often the case that it’s not until you need a service that you realise the crisis exists. Some people are so grateful to finally receive support that the length of time taken for it to materialise blurs into the background. Another postcode lottery in existence as some areas struggle to recruit staff.

Reality TV programs are often criticised but I love them. They’re exactly the sort of program I can now watch as I don’t have to follow plots, remember characters or names etc. So the recent flood of Ambulance, Police and the wonderful 24 hours in A&E have allowed me to continue to watch the TV. But they’ve also opened up the world of these crumbling services from the other side of the fence – from the side of those who work in them. I hadn’t realised until watching that ambulance workers are twice as likely to have mental health issues.

Reality programmes shows services from the other side of the crisis. The call handlers, often young people, are exposed to traumatic calls and the abuse they are exposed to by the frustrated public is unacceptable, yet happens on a daily basis. As human beings we react to a situation by taking it out on the first person we speak to – it’s not the call handlers fault, when you ring 999 that an ambulance isn’t immediately available, yet many instinctively react as though it is.

On these programs you often see the inappropriate use of 999 service which takes precious resources away from those most in need. Those who have had too much to drink on a night out and fallen over or can’t stand up whose friends then ring 999……just one example.

The Ambulance crews and Police often say that when Social Care closes at night, or when Social Care fails in their duty to help, 999 is the only service that will guarantee to help, no matter how long it takes…..

In a previous life I worked in the call centre for NHS Direct as a non clinical supervisor. We too had ‘frequent callers’. Just as I still hear on these programs. The lonely, who often havn’t seen anyone in days, call 999 simply through the need to have someone care for them. Is this a Service issue or should Society take more responsibility?

We didn’t use to have all these services. Was this because there was no need, I doubt it. So what’s changed? Has society created the issue or has the existence of the NHS given us unrealistic expectations? Have we created an expectation that help will be instantly available?
Obviously it’s a combination of many circumstances.

What is clear, is that those in real need of help, are often denied it.

Accident and Emergency – another service that no longer has ‘Winter Pressures’, but ‘All Year Round’ pressures. Once again, you see so many people inappropriately using this service. Has it become too accessible being another service that never closes? Is it the easy/only option for many? Instead of looking to the pharmacist, looking to Minor Injuries Units, GPs, and asking themselves ‘what might be another, better option’?
It’s difficult when you’re in that position, maybe panicking, maybe not knowing what else is in your area, so maybe we’re not educating people in the right use of services?

As for mental health services….well to say its broken already is an understatement. With all the publicity recently on being open about mental health issues, you would think the service was getting better…….but…….

Since when was it acceptable to assess someone urgently referred by their Gp by phone? They have no personal connection, no rapport. no sight of the distressed face, the broken person. But it allows them to have that detachment,  no personal connection and enables them to say they don’t need help,  what sort of service and help is that? How does that help the person? In fact it makes them feel worse. But because it’s so underfunded, this wall of impersonal support allows them to close the door on those in need. I also don’t condone the lack of empathy, compassion and understanding that this method allows some staff to use on the faceless phone either.

On one of the Ambulance programs that focussed on Mental Health, a crew were sent to a man so desperate for help he’d climbed onto the roof of a hospital, threatening to jump. He’d consistently asked for help from the mental health team. Even I, as a lay person could see his desperation. What saddened me most was the last time he had actually seen someone from the mental health service face to face and in desperate need of help, they’d handed him a piece of paper, and on that piece of paper was the number for the Samaritans………the crew persuaded him to climb down with the promise of help.
He was grateful, but of course, we then see that all crisis beds are full, so he was taken to A&E where the circle of crisis would start all over again.

Mental Health and Social Care and the services most in need and the two which have already crumbled.

Of all the services I’ve mentioned, it’s the system, not the staff at fault. A small percentage of staff have allowed frustrations to overflow into their relationship with patients and no longer know how to treat and talk to patients at a time when they need empathy and understanding.

Having worked in the NHS for 20 years, I’ve seen the crisis build. Underfunding by the government, inappropriate use of services. We take it for granted that this wonderful institution will always be there. But will it? If we continue to bombard this wonderful Institution, the Institution that is envy the world over, if we continue to underfund and use incorrectly, it will undoubtedly collapse. Surely we need compromise, we need education, rules on use, and yes, we need the government to provide more funding. It needs urgent resuscitation…

The world is changing, the world is ageing, so we need to think differently about the services needed. I remember this discussion taking place many, many years ago…..why does change take so long? In my opinion new governments come and go and restart, replan, revisit. The proverbial 2 steps forward 10 steps back. Isn’t it time those in the know tell the government what is needed and the government, elected by the people, are told what is needed, no matter what their political persuasion?

As for Dementia Services and Social Care…..well, that’s even more depressing and at some point may well have a blog all to itself…..

Just my thoughts….. my ramblings …..